Summary about Disease
Bladder neck contracture (BNC) is a narrowing or scarring of the bladder neck, the area where the bladder connects to the urethra. This obstruction can hinder the flow of urine from the bladder, leading to various lower urinary tract symptoms. It commonly arises as a complication following prostate surgery or other surgical interventions in the area, but can occasionally occur from other causes.
Symptoms
Symptoms of bladder neck contracture include:
Weak urinary stream
Urinary frequency
Urgency
Straining to urinate
Incomplete bladder emptying
Urinary retention (inability to urinate)
Recurrent urinary tract infections
Causes
The most common cause of bladder neck contracture is:
Prostate surgery (e.g., transurethral resection of the prostate (TURP), radical prostatectomy) Other causes include:
Radiation therapy to the pelvic area
Trauma or injury to the pelvis or urethra
Infection
Congenital abnormalities (rare)
Medicine Used
Medications are generally not the primary treatment for bladder neck contracture. While alpha-blockers may be prescribed to relax the bladder neck and improve urinary flow temporarily, they do not address the underlying structural problem. The primary treatment is surgical.
Is Communicable
Bladder neck contracture is not a communicable disease. It is not infectious and cannot be spread from person to person.
Precautions
Since bladder neck contracture is often a complication of surgery, precautions primarily involve minimizing the risk of complications during and after procedures in the pelvic area. This may include:
Careful surgical technique
Appropriate catheter management after surgery
Monitoring for urinary symptoms after surgery and promptly addressing any concerns.
Following all post-operative instructions provided by your surgeon.
How long does an outbreak last?
Bladder neck contracture is not an "outbreak" in the infectious disease sense. Once a contracture develops, it is a chronic condition that will not resolve on its own. Symptoms persist until the contracture is treated (typically surgically).
How is it diagnosed?
Diagnosis typically involves:
Medical history and physical exam: Assessing symptoms and prior medical history.
Urine flow study (uroflowmetry): Measures the rate and volume of urine flow.
Post-void residual (PVR) measurement: Determines the amount of urine remaining in the bladder after urination.
Cystoscopy: A small scope is inserted into the urethra to visualize the bladder neck and urethra to identify the contracture.
Retrograde urethrogram or voiding cystourethrogram (VCUG): X-ray tests to visualize the urethra and bladder.
Timeline of Symptoms
The timeline of symptom development can vary. In post-surgical cases, symptoms may appear:
Weeks to months after the initial surgery.
Symptoms can develop gradually or relatively quickly.
The condition will progressively worsen without intervention.
Important Considerations
Early diagnosis and treatment are important to prevent complications such as urinary retention, bladder damage, and kidney problems.
Treatment options are primarily surgical, including procedures to cut or remove the scar tissue causing the contracture.
Recurrence is possible even after surgical treatment.
Individual treatment plans will vary based on the severity of the contracture, overall health, and patient preferences.